Role of coxsackievirus B4 in the pathogenesis of type 1 diabetes.
Environmental factors, especially viruses, are thought to play an important role in the initiation or acceleration of the pathogenesis of type 1 diabetes (T1D). Data from retrospective and prospective epidemiological studies strongly suggest that enteroviruses, such as coxsackievirus B4 (CV-B4), may be associated with the development of T1D. It has also been shown that enterovirus infections are significantly more prevalent in at-risk individuals such as the siblings of diabetic patients, when they develop anti-beta-cell autoantibodies or T1D, and in recently diagnosed diabetic patients, compared with control subjects. The isolation of CV-B4 from the pancreas of diabetic patients supports the hypothesis of a relationship between the virus and the disease. Furthermore, studies performed in vitro and in vivo in animal models have increased our knowledge of the role of CV-B4 in T1D by helping to clarify the pathogenic mechanisms of the infection that can lead to beta-cell destruction, including direct virus-induced beta-cell lysis, molecular mimicry, 'bystander activation' and viral persistence. The role of enteroviruses as the sole agents in T1D, and a causal link between these agents and T1D, have not yet been established, although arguments that support such a role for these viruses in the pathogenesis of the disease cannot be ignored.
Jaïdane
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Laboratoire de virologie/UPRES EA3610, faculté de médecine, université Lille-2, CHRU de Lille, centre de biologie pathologie et parc Eurasanté, 59037 Lille, France.
Hober
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D000818:Animals; D024201:Bystander Effect; D003384:Coxsackievirus Infections / Q000150:complications*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000821:virology*; D004195:Disease Models, Animal; D029822:Enterovirus B, Human / Q000472:pathogenicity / Q000502:physiology; D006801:Humans; D050417:Insulin-Secreting Cells / Q000473:pathology / Q000821:virology; D011446:Prospective Studies; D012189:Retrospective Studies; D014779:Virus Replication